http://journals.lww.com/nursingresearchonline/pages/collectiondetails.aspx?TopicalCollectionId=5
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http://journals.lww.com/nursingresearchonline/Fulltext/2008/05000/Getting__to_the_Point___The_Experience_of_Mothers.3.aspx
Background: If individuals with mental illness become violent, mothers are most often victims, yet there is little available research addressing how, when, and from whom mothers seek help for themselves or their children when they become victims of this form of familial violence.
Objectives: To describe how mothers understood violence their adult children with mental illness exhibited toward them and to articulate the process mothers used to get assistance and access mental health treatment when this violence occurred.
Method: Grounded theory methods were used to explore and analyze mothers' experiences of violence perpetrated by their adult children with mental illness. Eight mothers of adult children who are violent with a diagnosed Diagnostic and Statistical Manual of Mental Disorders Axis I disorder participated in one to two open-ended interviews. Mothers were of diverse ethnic backgrounds.
Results: Getting immediate assistance involved a period of living on high alert, during which mothers waited in frustration for their children to meet criteria for involuntary hospitalization. This was a chaotic and fearful period. Fear and uncertainty eventually outweighed mothers' abilities to manage their children's behavior, at which time they called the police or psychiatric evaluation teams who served as gatekeepers to mental health treatment. Mothers accepted the consequences of being responsible for their children's involuntary hospitalization or of being left home with their children if the gatekeepers did not initiate involuntary hospitalization.
Discussion: Mothers can identify signs of decompensation in their children who are ill and recognize their need for hospitalization. They cannot, however, always access mental health treatment due to their children's refusal or failure to meet legal criteria for involuntary hospitalization. Mothers' inability to intervene early sometimes results in their own violent victimization.]]>Mon, 29 Mar 2010 20:40:21 GMT-05:0000006199-200805000-00003http://journals.lww.com/nursingresearchonline/Fulltext/2008/05000/Physical_Injuries_Reported_on_Hospital_Visits_for.4.aspx
Background: Violence is a recognized health risk to the mother, fetus, and infant during pregnancy and first-year postpartum (pregnancy-associated period). Although homicide is a leading cause of injury death among pregnant and postpartum women, the continuum of violence-related physical injuries that women sustain during this period has not been studied systematically.
Objective: To describe the patterns of physical injuries reported on hospital visits for assault during pregnancy and the postpartum period for a population cohort of Massachusetts women.
Methods: Using a retrospective cohort design with linked Massachusetts natality and hospital data from 2001 through 2005, 1,468 women (0.9%) who had 1,675 hospital visits (emergency department, observation, and inpatient) for assault were identified. Of these visits, 1,528 visits had at least one physical injury diagnostic code (800-999) from the International Classification of Disease, Ninth Edition, Clinical Modification (ICD-9 CM). Applying a modified Barell injury diagnosis matrix that uses the ICD-9 CM injury codes, the first physical injury noted for each visit was classified by body region and nature of injury. Then, the distributions of physical injuries by body region and nature of injury during pregnancy, postpartum, and overall pregnancy-associated periods are described. Also listed are those physical injuries reported in more than 5% of hospital visits for assault during either pregnancy or postpartum period.
Results: Of the 1,528 hospital visits for assault with physical injury, the head and neck were the most frequently injured body regions overall (42.2%). The percentage of torso injuries during pregnancy was more than twice that in the postpartum period (21.5% vs. 8.7%). The leading physical injury during both pregnancy (25.4%) and the postpartum (23.1%) period was superficial or contusion to the head and neck. Other common injuries differed by period.
Discussion: Patterns of physical injuries reported on hospital visits for assault for a population cohort provide information that could prove helpful in intervention programs.]]>Mon, 29 Mar 2010 20:45:27 GMT-05:0000006199-200805000-00004http://journals.lww.com/nursingresearchonline/Fulltext/2008/05000/Use_of_Brief_Tools_to_Measure_Depressive_Symptoms.5.aspx
Background: Nurses play a crucial role in the routine assessment of depression. However, brief depression assessment tools-necessary for busy clinical settings-have not been evaluated to identify depression in women with histories of intimate partner violence.
Objective: To evaluate the utility of two 5-question subsets from the Center for Epidemiologic Studies-Depression (CES-D) scale in detecting depressive symptoms in women with abuse histories.
Methods: The sample comprised 448 women involved in police- or court-reported incidents of intimate partner violence who completed a questionnaire used to assess depression with the 20-item CES-D scale. Receiver operating characteristic (ROC) analysis was used to identify score thresholds for two 5-question subsets from the CES-D for detecting (a) depressive symptoms and (b) severe depressive symptoms. Depression prevalence was estimated using score thresholds identified in the ROC analysis. The discriminating ability of the CES-D question subsets was also evaluated.
Results: Using thresholds identified in the ROC analyses, sensitivities ranged from .94 to .95 according to the CES-D question subsets for depressive symptoms and .97 to .98 for severe depressive symptoms. Specificity ranged from .73 to .87. Depression prevalence according to the 20-item CES-D was 84% for depressive symptoms and 67% for severe depression. Depression prevalences were 81%-84% (depressive symptoms) and 72% (severe depressive symptoms) using the CES-D question subsets. The two CES-D question subsets were comparable in their ability to identify minor and severe depressive symptoms, using the 20-item score as the gold standard (area under the curve range = .96-.97).
Discussion: Two brief question subsets were effective in identifying depression and can be used by nurses to assess depression in women with histories of abuse.]]>Mon, 29 Mar 2010 20:46:10 GMT-05:0000006199-200805000-00005http://journals.lww.com/nursingresearchonline/Fulltext/2008/05000/Effect_of_Violence_Exposure_on_Health_Outcomes.6.aspx
Background: Although youth are exposed to many forms of violence, most studies have been concentrated on only one type of violence exposure and focused on older adolescents or very young children. Little is known about direct and indirect effects of violent stressors on the health of African American adolescents in urban middle schools or the cumulative effect of multiple forms of exposures.
Objective: To test theoretically derived relationships between the types and levels of violence exposure and experiences; coping; and physical, behavioral, and mental health outcomes.
Methods: A structural equation modeling approach was used in this cross-sectional predictive correlational model testing design. Youth's experiences with exposure to and witnessing of violence were examined on three levels-community, family, and peer-in relation to physical, behavioral, and mental health outcomes. The sample (n = 309) consisted almost entirely of African American seventh graders from four urban middle schools. Forty-two percent of students were boys. More than 80% said that they had been in a boyfriend or girlfriend relationship, and 55% were currently in such a relationship.
Results: Eight of the 15 paths tested in the hypothesized model were found to be statistically significant, indicating an average fit (χ2 = 133.06, df = 40, ratio of 3.3, p Mon, 29 Mar 2010 20:46:41 GMT-05:0000006199-200805000-00006http://journals.lww.com/nursingresearchonline/Fulltext/2008/05000/Childhood_Sexual_Abuse_by_a_Family_Member,.7.aspx
Background: Little is understood about neuropathophysiology and neuroendocrinology associated with childhood sexual abuse by a family member in females who commit homicide.
Objectives: To determine if females sexually abused by a family member as a child also experienced more childhood physical abuse, had more neurological histories including traumatic brain injuries (TBIs), displayed more homicidal behaviors, and had abnormal diurnal variation in the stress hormone cortisol compared with females not sexually abused by a family member.
Methods: A cross-sectional study was conducted with 137 female inmates, including 9 murderers and 12 noncriminal females, with logistic regression statistical analysis comparing females who have (n = 60) and have not (n = 89) been sexually abused by a family member, as determined by Muenzenmaier's Childhood Abuse Scale.
Results: Final multivariate logistic regression model controlling for higher numbers of incarcerated adult family members (odds ratio [OR] = 1.63, p = .01) revealed that female victims of childhood sexual abuse by a family member experienced more childhood physical abuse (OR = 1.09, p = .05), experienced more TBIs (OR = 1.49, p = .01), and displayed increased violent behaviors including homicide (OR = 1.67, p = .05) compared with those not sexually abused by a family member. In univariate analysis, females sexually abused by a family member also experienced more sexual abuse by a non-family member (OR = 1.21, p = .036), more hospital visits for abuse injuries (OR = 1.27, p = .03), and more recent abuse (OR = .95, p = .008). Childhood sexual abuse by a family member was related significantly to decreased diurnal cortisol variation (OR = .087, p = .044) when controlling for number of years since last abuse, number of incarcerated adult family members, body mass index, depression, and TBIs.
Discussion: Risks associated with sexual abuse by a family member should be considered for individuals and policies to prevent potential homicide by those who experienced it. Further study is needed.]]>Mon, 29 Mar 2010 20:47:19 GMT-05:0000006199-200805000-00007http://journals.lww.com/nursingresearchonline/Fulltext/2008/05000/Mental_Health_After_Sexual_Violence__The_Role_of.8.aspx
Background: Sequelae of sexual violence include a range of physical and emotional problems, and negative mental health outcomes are particularly severe and long lasting.
Objectives: To evaluate associations among sociodemographic and behavioral factors and mental health after exposure to sexual violence.
Methods: Participants were 780 men and women who experienced sexual violence who participated in the 2005 South Carolina Behavioral Risk Factor Surveillance Survey. The factors analyzed were gender, age, race, income, and education; having health insurance, an identified healthcare provider, and adequate emotional support; and diet, exercise, smoking, and alcohol use. Poor mental health was defined as 5 or more poor mental health days in the past 30 days. Data were analyzed using the SAS Procedures for Analysis of Sample Survey Data.
Results: Victims of sexual violence were at greater risk of experiencing 5 or more poor mental health days than those who did not (95% confidence interval for odds ratio = 2.05-3.07, p < .0001). Poor mental health among those who experienced sexual violence was associated with younger age (p = .005), lower income (p = .02), lower educational attainment (p = .0007), lack of emotional support (p = .0001), and lack of health insurance (p = .03). Gender, race, and having an identified healthcare provider were not associated significantly with mental health. Behavioral factors significantly associated with better mental health (after controlling for socio-economic status) were healthy diet (p = .05), exercise (p = .02), and not smoking (p = .0001). Alcohol use was not associated with mental health.
Discussion: Treatment after sexual violence should include attention to risk factors including low income, low educational attainment, and lack of emotional support and to the protective influence of behavioral factors including a healthy diet, exercise, and not smoking. Comprehensive integrated models of care addressing mental, physical, and social sequelae of sexual violence are needed.]]>Mon, 29 Mar 2010 20:47:53 GMT-05:0000006199-200805000-00008http://journals.lww.com/nursingresearchonline/Fulltext/2008/05000/Nurturing_the_Research_Vision__Violence,_Injury,.2.aspx
No abstract available]]>Thu, 15 Apr 2010 10:54:21 GMT-05:0000006199-200805000-00002http://journals.lww.com/nursingresearchonline/Fulltext/2015/11000/Future_Expectations,_Attitude_Toward_Violence,_and.3.aspx
Background: Hopeful future expectations have been linked to positive developmental outcomes in adolescence; however, the association between future expectations and bullying perpetration has received less attention.
Objectives: We examined the relationship between future expectations and physical and relational bullying perpetration and tested a mediation model that linked future expectations with bullying through attitude toward violence.
Methods: Structural equation modeling was used to examine the relationship between future expectations and bullying perpetration (relational and physical) and to test whether these relationships were mediated by attitude toward violence in a sample of U.S. seventh-grade students (Mage = 12.86 years, N = 196, 60% female, 46% African American).
Results: Attitude toward violence fully mediated the relationship between future expectations and physical bullying (indirect effects = −0.08, 95% CI [−0.15, −0.01], R2 = .17). The relationship between future expectations and relational bullying was partially mediated by attitudes toward violence (indirect effects = −0.07, 95% CI [−0.14, −0.002], R2 = .20).
Discussion: Our findings suggest that future expectations can play a role in reducing attitude toward violence and physical and relational bullying perpetration among youth. Interventions that help support the development of future goals and aspirations could play a vital role in bullying prevention efforts.]]>Wed, 28 Oct 2015 14:49:12 GMT-05:0000006199-201511000-00003